Using machine learning to classify patients on opioid use.

objectivesHigh-frequent opioid use tends to increase an individual's risk of opioid use disorder, overdose and death. Thus, it is important to predict an individuals' opioid use frequency to improve opioid prescription utilization outcomes.

methodsIndividuals receiving at least one opioid prescription from 2016 to 2018 in the national representative data, Medical Expenditure Panel Survey, were included. This study applied five machine learning (ML) techniques, including support vector machine, random forest, neural network, gradient boosting and XGBoost (extreme gradient boosting), to predict opioid use frequency. This study compared the performance of these ML models with penalized logistic regression. The study outcome was whether an individual lied in the upper 10% of the opioid prescription distribution. Predictors were selected based on Gelberg-Andersen's Behavioral Model of Health Services Utilization. The prediction performance was assessed using the area under the receiver operating characteristic curve (AUROC) and the area under the precision-recall curve (AUPRC) in the test data. Patient characteristics as predictors for high-frequency use of opioids were ranked by the relative importance in prediction in the test data. KEY

findingsRandom forest and gradient boosting achieved the top values of both AUROC and AUPRC, outperforming logistic regression and three other ML methods. In the best performing model, the random forest, the following characteristics had high predictive power in the frequency of opioid use: age, number of chronic conditions, public insurance and self-perceived health status.

conclusionsThe results of this study demonstrate that ML techniques can be a promising and powerful technique in predicting the frequency of opioid use and health outcomes.